Basic Information
Provider Information
NPI: 1619052859
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AVRIN
FirstName: SARAH
MiddleName: LOUISE
NamePrefix: DR.
NameSuffix:  
Credential: PH.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1290 CHAMBERS RD
Address2:  
City: AURORA
State: CO
PostalCode: 800117117
CountryCode: US
TelephoneNumber: 3036172300
FaxNumber:  
Practice Location
Address1: 791 CHAMBERS RD
Address2:  
City: AURORA
State: CO
PostalCode: 800117112
CountryCode: US
TelephoneNumber: 3036172200
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/26/2006
LastUpdateDate: 03/15/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/15/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103TC0700X2114COY Behavioral Health & Social Service ProvidersPsychologistClinical

No ID Information.


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